Assessment of the nocturnal blood pressure relative to sleep stages in patients with obstructive sleep apnea.

To determine the mean blood pressure relative to sleep stages, two nocturnal cardiorespiratory polysomnographs were recorded in 60 male patients with hypertension and obstructive sleep apnea (OSA). The mean age was 50.2 years, the BMI 32.0 kg/m2, the respiratory disturbance index (RDI) 44, and the blood pressure by the WHO protocol 158/98 mm Hg. A new evaluation program was used to determine the invasively measured mean arterial pressure (mean +/- SEM) and heart rate (mean +/- SEM) during sleep (mean total sleep time 361 +/- 48 min) referred to sleep stages 1 (99.5 +/- 1.5 mm Hg/67.6 +/- 1.1 bpm), 2 (98.7 +/- 1.6 mm Hg/66.6 +/- 1.1 bpm), 3 (97.6 +/- 1.8 mm Hg/67.4 +/- 1.3 bpm), and 4 (97.6 +/- 2.2 mm Hg/66.3 +/- 1.6 bpm) and to REM sleep (103.3 +/- 1.7 mm Hg/68 +/- 1.2 bpm) as 1 s mean values and to compare them with the waking state (98.3 +/- 1.6 mm Hg/83.6 +/- 1.1 bpm). There was no physiological fall in blood pressure in patients with pronounced OSA. Sleep-stage-specific analysis of invasive continuous blood pressure signals is the gold standard. The sleep structure is disturbed less than with other methods.